Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 04007 | Date 14/08/2020 |
| Token No | SM/19-20/8837 14/08/2020 | Serial | 008 |
| Patient Name | Mr. MUKUNDA SHA | Contact No | 8777468154 |
| Address | 28/A TIN BAZAR, BYE LANE | Age | 50 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||